We tried to understand what he was saying when we saw him walking on the downtown streets of Santo Domingo, but he made little sense as his words were slurred together. His appearance was disheveled and his clothing dirty. He was standing in the middle of the road when I walked away.

Mental illness in the Dominican Republic is similar to the problem we face in America. A lot of it goes untreated.

The World Health Organization reported on the Dominican, “With respect to financing of mental health services, this study shows that allocation of resources is very low. SESPAS allocates less than 1% (0.38%) of health care expenditures to mental health services, and 50% of these resources are directed towards Padre Billini Mental Hospital.”

In addition to the one dedicated mental hospital (only 150 beds), there are also 56 mental health outpatient facilities in the country, of which 4% are for children and adolescents only. However, there is no review body to oversee inspections at the mental hospital in the Dominican nor sanctions on any of the facilities that violate a patients’ rights. Furthermore, physical restrain or seclusion of patients is not monitored by any organization in the Dominican Republic, according to the World Health Organization in 2008.

What I found interesting is that the World Health Organization reported that 30% of the patients in the single mental hospital in a rural area of the country, have been patients for 10-years or more. In other words, new treatment for patients is hard to come by. Affective disorders (depression, bipolar disorder, and anxiety disorder) and schizophrenia are the most common mental disorders in the Dominican.

Families have stepped up to monitor mental health care facilities in the Dominican. 45 family members have formed committees to defend the rights of persons with mental disorders in the country.

A 2011 report by the World Health Organization showed that the majority of primary health care doctors and nurses in the Dominican have not received official in-service training on mental health within the last five years. So the problems continue to grow. The American Public Health Association reported this year (2015) that residents in low income countries fail to receive care for mental health. The organization wrote, “80% of patients with severe mental illness do not receive necessary care.”